Jake Jameson is
an architect who came of age in immediate post World War II London. He grew up
in “the wilderness” of the English moors and peat bogs far from London. He
returns to this wilderness with a wife and an infant son, and to where his
mother, a childhood friend, and many memories still live. We read about his
successful career, his Jewish mother and her flight from her native Austria,
his marriage to Helen and her unexpected death after about 30 years of
marriage, his infidelities, his son’s incarceration in a prison he designed,
his daughter’s death as a young child, and how eventually the wilderness he
lived in moved from the moors to his brain. We don’t learn all of this easily
because it comes in one form through Jake’s damaged memory and in another form
through the tellings of more reliable witnesses. We are left in our own
confused state about certain parts of story until the corrections and
clarifications come later in the book. For example, we can go far into the
novel thinking that Helen could have died from falling from a cherry tree until
we learn near the very end that she died from a stroke, probably.

Extremis, a Netflix documentary directed by
Dan Krauss, follows Dr. Jessica Zitter a palliative care ICU physician at
Highland Hospital in Oakland, California. The documentary begins with an exasperated
Dr. Zitter trying to communicate with a patient on a ventilator: “Is this about
the breathing tube? You want it out?” she asks. When the patient nods in
affirmation, Dr. Zitter replies, “What if you die if I take it out?” The
questions confronting the physicians, patients and their loved ones get no
easier over the course of the film. The
documentary is propelled by a dramatic tension between its protagonists: on one
side Dr. Zitter, who is compassionate but dogmatically pragmatic, on the other
side the family members of patients who are driven above all by hope and faith.
This tension manifests itself in palpable ways. In one particularly powerful
scene, a patient’s daughter says to Dr. Zitter: “it would feel like murder to
pull that life support. That’s what it would feel like to me…I feel like maybe
as a doctor, you know, being as smart, and being as knowledgeable, and being
inside medical journals, it can dwindle your optimism a little bit.” Dr. Zitter
replies simply, “I’m just trying to help you make a decision that’s right for
your Mom.”
Of course,
for Dr. Zitter there does appear to be a categorically appropriate decisionin all of these cases. In most of her conversations, she is transparently trying to get
family members to see that there is no realistic chance of meaningful recovery for
their loved ones. That is not to say that she is insensitive to the family’s
wishes or the complex bioethical conundrums which arise around her. In fact,
her bravery and deftness in broaching these serious and difficult topics is on
full display throughout the film.

The subject of Psychobook is psychological tests, both classic tests and newly created ones. Oversized, with more pictures than text, it is truly an art book.

Psychobook begins with an introduction by Lionel Shriver, a journalist and novelist, which proves to be a very personal indictment of psychological testing. There follows a more even-handed historical essay by Oisin Wall, a curator at the Science Museum in London.

The bulk of Psychobook is comprised of photographs of tests and archival material related to tests. For example, along with intelligence tests designed to screen potential immigrants, we find images of new arrivals being tested at Ellis Island. Likewise, we see beautifully reproduced Rorshach inkblots along with pictures of Rorshach and older inkblots that may have inspired him. The Thematic Apperception Test (TAT) is a projective test in which subjects respond to images with their fantasies. Here we see the 1930s originals cut out of magazines alongside updated images especially commissioned for this volume. Each is provocative in its own way. As an added bonus, a series of photographs of psychotherapists in their offices from the 1930s to the present is interspersed with the content on psychological testing.

The narrator Lucia works in a California city emergency room. Her job title is not specified - possibly a registration clerk or triage nurse. She enjoys working in the ER and marvels at the human body: "I am fascinated by two fingers in a baggie, a glittering switchblade all the way out of a lean pimp's back" (p90). Death, however, is a regular visitor.

All day, ambulances back up to the emergency room, gurneys rumble by, and charts accumulate. The staff is too busy. Patients are restless, frightened, and angry. She notes how everything associated with the ER appears gray - patient's skin, blankets, emergency vehicles. And perhaps the prognosis of patients as well: "Everything is reparable, or not" (p90).

Lucia describes Code Blues, the deaths of gypsies, an encounter with a blind man whose wife was DOA, drunks, and suicide attempts. She wonders why the elderly fall down so frequently. She's frustrated by the large number of people who come to the ER without an actual emergency and longs for "a good cut-and-dried stabbing or a gunshot wound" (p93). But Lucia worries that she has become too desensitized working in the emergency room, maybe even inhuman. Yet the flow of patients doesn't slow down - those with true life-threatening conditions and those who probably don't need to be there.

It is a strange and cruel world that Amelia finds herself in. The 17-year-old woman from Mexico who speaks very little English travels to Oakland, California to marry her boyfriend Manolo. Soon after, he is sentenced to 8 years in prison. Amelia is already pregnant. She and her newborn son, Jesus Romero, move in with Manolo's aunt and uncle. Amelia refers to the baby as "mijito" (an affectionate Spanish term for "little son"). He cries constantly and has a hernia that requires repair. But the teenage mother is overwhelmed and frightened. She receives little support.

Amelia and Jesus go to the Oakland Children's Hospital where they meet a cynical but kind nurse who works with a group of 6 pediatric surgeons. Most of the surgical practice consists of Medi-Cal welfare patients and lots of illegal aliens. The nurse encounters crack babies, kids with AIDS, and plenty of disabled children. When the surgeon examines Jesus, he notes bruises on the baby's arms. They are the result of Amelia squeezing him too hard to stifle his incessant crying. Surgery is scheduled but doesn't get done.

Later, the uncle makes sexual advances and, while drunk, rapes Amelia in the bathroom. The aunt insists Amelia and Jesus leave the apartment. She deposits them at a homeless shelter. Amelia spends her days riding buses and her nights at the shelter where she is harassed and robbed. All the while, Jesus cries. Amelia notices his hernia is protruding and she is unable to push it back in place as she was instructed. After office hours, the same nurse evaluates the situation and accompanies them to the emergency room where surgery is performed.

Amelia and Jesus return to the ER. She has been sedated and is staring blankly. Jesus is dead with a broken neck. The nurse from the surgical clinic is at Amelia's side and learns that Jesus was crying in the homeless shelter and keeping others there awake. Amelia shook the infant to try to quell the crying. She didn't know what else to do.

This ambitious novel presents unusual events ten years after
an international adoption. Because of
the Chinese one-child policy, Chinese peasant woman Xiao Lu abandons her second
daughter Chun in a rural market, knowing that the child will be sent to an
orphanage. An American couple adopt the child, calling her Katie. As a
celebration for Katie’s tenth birthday, they return to southwest China, hoping
to meet the birth mother.

In a series of unusual events, they find Xiao Lu, and it is,
at first, a joyous event. Troubles mount, however, as the birth mother wants
Katie to stay with her, and Katie feels a mystical bond between them. Xiao Lu,
having left her husband, now lives as a hermit in a hut on the slopes of The
One Hundred Mile Mountain. She sweeps the 100 steps of The Elephant Temple
daily and practices calligraphy in her hut.

Pep and Clio Macy, having married late, could not get
pregnant. The novel satirizes them as aging Yuppies,
spoiled and materialistic.
Clio wears a Movado watch worth hundreds if not thousands of dollars. The
family’s cockerpoo has been boarded at home. Katie dislikes being the only Chinese
American in her private school.
After the birth mother has been found, the mood of the book changes.
Xiao Lu wants her child returned, and the Macys fear that they are in danger.
In the last 100 pages, nature itself attacks the Americans with snakes, monkeys,
bats, a huge millipede, and even the weather. Pep is injured and receives rough,
traditional medical treatment from a monk; it appears to be effective, however,
in healing his heart physically and spiritually—a resonance with the book’s
title. Katie becomes more and more like Xiao, learning calligraphy and some
Chinese language. When Xiao is grievously injured by the monkeys, the Macys effectively
care for her, and previous conflicts are resolved.

The
collection is prefaced and named for a poem by Walt Whitman, The Wound Dresser,
annotated in this database by Jack Coulehan. In “On Reading Walt Whitman’s ‘The Wound Dresser’” Coulehan sees Whitman as a nurse
tending the Civil War wounded, and, while using some of the words and language
of Whitman’s poem, imagines himself moving forward in that created space of
caring for patients: “You remain / tinkering at your soldier’s side, as I step
/ to the next cot and the cot after that.” (p. ix) The poem introduces us to
all the ‘cots’ of the book – where we step from patient to patient, through
history and geography, and through the journey of medical training.
The
book is comprised of 4 sections without overt explanation, although there are 4
pages of Notes at the end of the book with information about select individual
poems. In general, the themes of the sections can be described as: 1.) clinical
care of individual patients and medical training; 2.) reflections on historical
medical cases, reported anecdotes or past literary references; 3.) meditations
on geographically distinct episodes – either places of travel or news items;
and 4.) family memoir, personal history and the passage of time.
Many
of the poems have been previously published and a few are revised from an
earlier chapbook. Notable among the latter is “McGonigle’s Foot” (pp 42-3) from
section 2, wherein an event in Philadelphia, 1862 – well after the successful
public demonstration of anesthesia was reported and the practice widely
disseminated, a drunk Irishman was deemed unworthy of receiving an anesthetic.
Although it is easy to look back and critique past prejudices, Coulehan’s poem
teaches us to examine current prejudices, bias and discrimination in the
provision of healthcare choices, pain relief and access to care.
There
are many gems in these 72 poems. Coulehan has an acute sensibility about the
variety of human conditions he has the privilege to encounter in medical
training and clinical practice. However, one of the standouts for me was “Cesium
137” based on a news report of children finding an abandoned radiotherapy
source (cesium) in Goiania Brazil, playing with the glowing find and suffering
acute radiation poisoning. He writes: “the cairn of their small lives / burst
open…their bodies vacillate and weaken / hour by hour, consumed by innocence /
and radiant desire.” (p. 68).
Following
another poem inspired by Whitman, Coulehan concludes the collection with a
sonnet “Retrospective.” He chronicles a 40-year career along with physical
aging, memories of medical training “etched in myelin,” and the search for
connection across that span of career including, “those he hurt, the woman / he
killed with morphine, more than a few he saved.” Ultimately, he relies on hope
with fitting understatement: “His ally, hope, will have to do.” (p. 97)

As the
movie opens, the married artists Einar and Gerda Wegener are working out of
their apartment in Copenhagen. The year is around 1908 and they have been married
for just a few years. They do not have children as yet, but they have hopes
that they would soon.

Einar
is a painter of Scandinavian landscapes and Gerda is a figurative painter. When
the model for a painting Gerda is working on fails to appear one day, she asks
Einar to take the model’s place. Einar would need to pose with the model’s
dress and assume a feminine posture. In posing as a woman, Einar's simmering desire to become a woman comes to a boil.

At
first Gerda finds Einar’s interest in posing as a woman an interesting
diversion and as a means to have some fun at various social events. But, Einar becomes more and more serious about his interest in transitioning to a
woman in more than just wardrobe and affect. As an early step in that
direction, he takes on the name Lili Elbe and the pronoun "she." She gives up
painting and becomes Gerda’s primary model. Gerda’s
paintings become highly sought after with her new model.
Lili’s quest to become a woman intensified
over the subsequent years and extended to hoping to acquire a uterus so
that she could give birth. With Gerda’s help, Lili eventually finds a surgeon
in Germany who is willing to perform a series of risky procedures that will
make her into a woman. After the operations, Lili was
transformed into the woman she wanted to be, but without the availability of
anti-rejection drugs and antibiotics, she died in the hospital with Gerda at
her side.

Talking with Doctors, a memoir by David Newman,
follows the author’s dizzying journey to find a physician and treatment plan after
being diagnosed with a rare malignant tumor perched dangerously near his brain
stem. Despite the author’s education, money, connections and geographic
privilege (Mr. Newman is a New Yorker surrounded by “the best” hospitals and
the “the best” doctors), he finds himself struggling to make any sense of the
conflicting medical advice he receives. The vertigo induced by the deluge of
advice he gathers in his countless trips to multiple medical centers, is only
exacerbated by the egotism and childishness of some of the doctors he sees. The
indecencies range from the routine—waiting hours for doctors that are running
behind schedule—to the utterly bizarre—a doctor returning Mr. Newman’s $10
copay as a gesture of good will after explaining that his tumor was inoperable
and would likely be fatal.
Mr.
Newman’s career as a psychotherapist is intimately interwoven into the fabric
of the memoir. His analytical eye strongly informs his search for a physician
whom he can trust. Moreover, knitted into the narrative is Mr. Newman’s
experience with his own patients whom he is forced to refer to other
therapists while he is receiving treatment.
Coloring
the tone of the entire memoir is the fact that Mr. Newman has survived the
tumor around which the memoir is framed. Nonetheless, Talking with Doctors is a harrowing and suspenseful read.

In this painting, Edvard Munch shows, as the center of attention, a stricken young girl, propped on a thick white pillow, covered with a heavy blanket, at the end of her short life. A grieving companion sits next to her, her head so deeply bowed that we can only see the top of her head, not her features. The companion is so overcome with grief that she can neither hold her head up, nor look at the dying girl. Only the young girl's haunting profile is visible, as she looks steadily toward a dark ominous drape, perhaps representing the unknown or the mystery of death. Her reddish hair appears thin, damp, and uncombed against the pillow.The two figures make contact by holding hands for comfort. The artist omits the details of fingers, and just indicates a simple connected shape for both hands. Striving for only simplified and essential forms, Munch enhanced each surface by impassioned brushstrokes, nuanced colors, and thick layers of impasto paint.